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Neonatal herpes simplex virus (HSV) infection (HSV infection in infants less than 6 weeks of age) is rare but mortality and morbidity rates are high after disseminated disease and encephalitis. In France, the epidemiology is poorly described, and two decades ago, incidence was estimated to be 3 per 100,000 live births a year. We describe determinants, epidemiologic and clinical characteristics of neonatal HSV infection in a managed-care population attending in two major obstetric and paediatric centres, Paris, France, over a 10-year period. This retrospective case series study was conducted from 2013 to 2023, in infants less than 42 days of age who had virologically confirmed HSV infection. We report an overall rate of neonatal herpes of 5.5 per 100,000 live births a year and an incidence of symptomatic cases of 1.2 per 100,000 live births a year. HSV-1 was the major serotype involved (84.2%) and post-natal acquisition through the orolabial route reached 63.2%. All neonates who had neonatal HSV PCR screening (owing to clinical signs in parents) and who received prompt acyclovir treatment remained asymptomatic. Symptomatic forms accounted for 21.1% cases of the total and mortality was high (62.5% of symptomatic forms). Conclusion: This case series confirms that neonates at risk for HSV disease and poor outcome are those born to HSV-seronegative mothers, preterm infants, and those who received acyclovir after onset of symptoms (mainly because mothers did not present evidence of acute HSV infection). Our study confirms the major role of HSV-1 and the frequency of its early post-natal acquisition. What is known: • Neonatal herpes simplex virus infection is rare but motality and morbidity rates are high after disseminted disease and encephalitis. National recommendations exist worldwide but mangement of this disease is not always easy. What is new: • As in France epidemiology of neonatal herpes is poorly described, our report is potentially an important addition to the existing literature. Moreover, we describe local practice that may be useful to physicians. [ABSTRACT FROM AUTHOR]

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are chemical substances spread throughout the environment worldwide. Exposure during pregnancy represents a specific window of vulnerability for child health. OBJECTIVE: Our objective was to assess the impact of prenatal exposure to multiple PFAS on emotional and behavioral functions in 12-y-old children. METHOD: In the PELAGIE mother–child cohort (France), prenatal exposure to nine PFAS was measured from concentrations in cord serum samples. Behavior was assessed at age 12 y using the parent-reported Strengths and Difficulties Questionnaire (SDQ) and the self-reported Dominic Interactive for Adolescents (DIA) for 444 children. Associations were estimated using negative binomial models for each PFAS. Bayesian kernel machine regression (BKMR) models were performed to assess the exposure mixture effect on children’s behavior. RESULTS: In our study population, 73% of mothers had spent more than 12 y in education. Higher scores on SDQ externalizing subscale were observed with increasing cord-serum concentration of perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) [adjusted mean ratio (aMR)=1.18, 95% confidence interval (CI): 1.03, 1.34, and aMR=1.14 (95% CI: 1.00, 1.29) for every doubling of concentration, respectively]. Results for the hyperactivity score were similar [aMR=1.20 (95% CI: 1.04, 1.40) and aMR=1.18 (95% CI: 1.02, 1.36), respectively]. With regard to major depressive disorder and internalizing subscales, perfluorodecanoic acid (PFDA) was associated with higher self-reported DIA scores [aMR=1.14 (95% CI: 1.01, 1.27) and aMR=1.11 (95% CI: 1.02, 1.21), respectively]. In terms of the anxiety subscale, PFDA and PFNA were associated with higher scores [aMR=1.11 (95% CI: 1.02, 1.21) and aMR=1.10 (95% CI: 1.01, 1.19), respectively]. Concurrent increases in the PFAS concentrations included in the BKMR models showed no change in the SDQ externalizing and DIA internalizing subscales scores. CONCLUSION: Prenatal exposure to PFNA and PFOA were associated with increasing scores for measures of externalizing behaviors, specifically hyperactivity. We also identified associations between PFNA and PFDA prenatal exposure levels and increasing scores related to internalizing behaviors (general anxiety and major depressive disorder), which adds to the as yet sparse literature examining the links between prenatal exposure to PFAS and internalizing disorders. [ABSTRACT FROM AUTHOR]

We report 3 cases of successful treatment of Microascus spp. bronchopulmonary infection in a multiple-traumatized patient and 2 lung transplant recipients in France. We emphasize the promising use of olorofim antifungal therapy in a rising context of intrinsically less-susceptible respiratory infections caused by mold. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Are persistent organic pollutants (POPs) associated with a diminished ovarian reserve (DOR) in women of reproductive age? SUMMARY ANSWER Amongst 17 POPs detected in over 20% of serum samples, only p,p′-DDE was significantly associated with an increased risk of DOR, and β-hexachlorocyclohexane (β-HCH) was significantly associated with a decreased risk of DOR whilst mixture analyses yielded non-significant associations and did not detect any interactions between POPs. WHAT IS KNOWN ALREADY Animal studies have shown that several POPs can alter folliculogenesis and increase follicle depletion. However, only a few studies have been conducted in humans, with small sample sizes and inconsistent results. STUDY DESIGN, SIZE, DURATION Our study included 138 cases and 151 controls from the AROPE case–control study. Study participants were women between 18 and 40 years of age recruited amongst couples consulting for infertility in four fertility centres in western France between 2016 and 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Cases of DOR were defined as women with anti-Müllerian hormone (AMH) levels ≤1.1 ng/ml and/or antral follicle count (AFC) <7, and controls were women with AMH levels between 1.1 and 5 ng/ml and AFC ≥ 7, without genital malformations and with a menstrual cycle length between 26 and 35 days. A total of 43 POPs (including 15 organochlorine pesticides, 17 polychlorinated biphenyls, and 9 polybromodiphenylethers) were measured in the serum at inclusion into the study. We conducted logistic regression adjusted for potential confounders using a directed acyclic graph to study the effect of each POP on DOR as single exposures, and used Bayesian kernel machine regression (BKMR) to measure the mixture effect of POPs on DOR. MAIN RESULTS AND THE ROLE OF CHANCE Of the 43 POPs, 17 were detected in over 20% of the serum samples. In the single-exposure multivariate logistic regressions, p,p′-DDE (median 165.0 IQR 161.0 ng/l in controls) as a continuous exposure was significantly associated with an increased risk of DOR (odds ratio (OR) 1.39, 95% CI 1.10–1.77) and non-significantly associated with an increased risk of DOR for the second and third terciles (OR 1.46, 95% CI 0.74–2.87, and OR 1.72, 95% CI 0.88–3.37, respectively). β-HCH (median 24.2 IQR 21.5 ng/l in controls) was significantly associated with a decreased risk of DOR when β-HCH was treated as a continuous exposure (OR 0.63, 95% CI 0.44–0.89) and for the third tercile of exposure (OR 0.43, 95% CI 0.21–0.84) and non-significantly associated with a decreased risk of DOR for the second tercile (OR 0.77, 95% CI 0.42–1.42). All sensitivity analyses confirmed our results. BKMR showed similar associations for single exposures but found no significant associations for the total mixture effect. In addition, the BKMR results did not suggest any interactions between POPs. LIMITATIONS, REASONS FOR CAUTION Controls were recruited amongst infertile couples and thus may not be representative of all women of reproductive age. However, their POP concentrations were in the same range as in the general French population. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to examine the associations between serum POPs and DOR. The well-recognized anti-androgenic properties of p,p′-DDE and estrogenic properties of β-HCH could explain these associations of opposite direction. If these results are replicated elsewhere, this could have an impact on fertility prevention messages and help in understanding the impact of POPs on the female reproductive system. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Fondation de France (grant numbers 2014-50537 and 00110196) and the French Biomedicine Agency (2016). None of the authors have any conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Introduction: One of the drawbacks of fetoscopic endoluminal tracheal occlusion (FETO) for congenital diaphragmatic hernia is the need for a second invasive intervention to reestablish airway patency. The "Smart-TO" (Strasbourg University-BSMTI, France) is a new balloon for FETO, which spontaneously deflates when positioned near a strong magnetic field, e.g., generated by a magnetic resonance image (MRI) scanner. Translational experiments have demonstrated its efficacy and safety. We will now use the Smart-TO balloon for the first time in humans. Our main objective is to evaluate the effectiveness of prenatal deflation of the balloon by the magnetic field generated by an MRI scanner. Material and methods: These studies were first in human (patients) trials conducted in the fetal medicine units of Antoine–Béclère Hospital, France, and UZ Leuven, Belgium. Conceived in parallel, protocols were amended by the local Ethics Committees, resulting in some minor differences. These trials were single-arm interventional feasibility studies. Twenty (France) and 25 (Belgium) participants will have FETO with the Smart-TO balloon. Balloon deflation will be scheduled at 34 weeks or earlier if clinically required. The primary endpoint is the successful deflation of the Smart-TO balloon after exposure to the magnetic field of an MRI. The secondary objective is to report on the safety of the balloon. The percentage of fetuses in whom the balloon is deflated after exposure will be calculated with its 95% confidence interval. Safety will be evaluated by reporting the nature, number, and percentage of serious unexpected or adverse reactions. Conclusion: These first in human (patients) trials may provide the first evidence of the potential to reverse the occlusion by Smart-TO and free the airways non-invasively, as well a safety data. [ABSTRACT FROM AUTHOR]

Purpose: The mobilization of most available hospital resources to manage coronavirus disease 2019 (COVID-19) may have affected the safety of care for non-COVID-19 surgical patients due to restricted access to intensive or intermediate care units (ICU/IMCUs). We estimated excess surgical mortality potentially attributable to ICU/IMCUs overwhelmed by COVID-19, and any hospital learning effects between two successive pandemic waves. Methods: This nationwide observational study included all patients without COVID-19 who underwent surgery in France from 01/01/2019 to 31/12/2020. We determined pandemic exposure of each operated patient based on the daily proportion of COVID-19 patients among all patients treated within the ICU/IMCU beds of the same hospital during his/her stay. Multilevel models, with an embedded triple-difference analysis, estimated standardized in-hospital mortality and compared mortality between years, pandemic exposure groups, and semesters, distinguishing deaths inside or outside the ICU/IMCUs. Results: Of 1,870,515 non-COVID-19 patients admitted for surgery in 655 hospitals, 2% died. Compared to 2019, standardized mortality increased by 1% (95% CI 0.6–1.4%) and 0.4% (0–1%) during the first and second semesters of 2020, among patients operated in hospitals highly exposed to pandemic. Compared to the low-or-no exposure group, this corresponded to a higher risk of death during the first semester (adjusted ratio of odds-ratios 1.56, 95% CI 1.34–1.81) both inside (1.27, 1.02–1.58) and outside the ICU/IMCU (1.98, 1.57–2.5), with a significant learning effect during the second semester compared to the first (0.76, 0.58–0.99). Conclusion: Significant excess mortality essentially occurred outside of the ICU/IMCU, suggesting that access of surgical patients to critical care was limited. [ABSTRACT FROM AUTHOR]

Objective: Evaluation of relevance and feasibility of universal newborn congenital cytomegalovirus infection (cCMVI) screening in saliva.Design: Retrospective, population-based cohort study.Setting: Clamart, France, 2016-2020.Population: All neonates born consecutively in our level III maternity unit.Methods: CMV PCR in saliva for all neonates at birth, and, if positive, CMV PCR in urine to confirm or exclude cCMVI. Prospective and retrospective characterisation of maternal infections. ROC curve analysis to assess saliva PCR performances. Acceptability of screening among staff members evaluated by a survey.Main Outcome Measures: Number of cCMVI neonates; number of expected and unexpected cCMVI.Results: Among 15 341 tested neonates, 63 had cCMVI (birth prevalence of 0.4%, 95% CI 0.3-0.5). In 50% of cases, maternal infection was a non-primary infection (NPI) during pregnancy. cCMVI was expected or suspected (maternal primary infection [PI], antenatal or neonatal signs) in 24/63 neonates (38%), and unexpected in 39/63 neonates (62%). The best CMV saliva threshold to predict cCMVI was 356 (2.55 log) copies/ml [95% CI 2.52 log-3.18 log], with an area under the ROC curve of 0.97. Over 90% of the 72 surveyed staff members reported that the screening was easy and quick. No parent refused the screening.Conclusions: Universal screening for cCMVI with CMV PCR on saliva samples is feasible and highly acceptable to parents and healthcare providers. Over half (62%) of the cases had no prenatal/neonatal signs of cCMVI or a maternal history of CMV infection during pregnancy and would probably not have been diagnosed without universal screening.Tweetable Abstract: In 62% of congenital cytomegalovirus infection cases, only universal neonatal screening in saliva can detect infection. [ABSTRACT FROM AUTHOR]

Aim: In coastal marine systems, biogenic reef‐building species have great importance for conservation as they provide habitat for a wide range of species, promoting biodiversity, ecosystem functioning and services. Biogenic reef persistence and recovery from perturbations depend on recolonization by new recruits. Characterizing larval dispersal among distant reefs is key to understanding how connectivity shapes metapopulation structure and determines network coherence; all of which are of critical importance for effective conservation. Location: Northeast Atlantic coast and western English Channel, France. Methods: We used a biophysical transport model to simulate larval dispersal of the reef‐building polychaete Sabellaria alveolata. We combined dispersal modelling and network analysis into a framework aiming to identify key reef areas and critical dispersal pathways, whose presence in the network is vital to its overall coherence. We evaluated changes in dispersal pathways constrained by different connectivity thresholds, i.e., minimum dispersal rate for the presence of a connection. We tested scenarios of sequential loss of reefs: randomly, by habitat quality (a score for reef status and occupancy in an area) or by betweenness centrality metric (BC; quantifying the proportion of shortest paths connecting all areas that are passing through any given area). Results: We found that the network of S. alveolata reefs forms two main regional clusters, the Atlantic coast and the English Channel, which are connected only through weak sporadic dispersal events. Within each cluster, the network is characterized by relatively high connectivity among neighbouring areas with reefs, maintained even under higher connectivity thresholds. Simulating scenarios of sequential loss of reefs further identified high centrality reefs, those with highest BC values, key to network coherence. Main conclusions: Effective conservation of this important reef habitat requires a network of protected areas designed to sustain a combination of locally important source reefs, and those that act as stepping stones connecting distant reefs. [ABSTRACT FROM AUTHOR]

Extreme droughts have a strong impact on agricultural production. In France, the 2003 drought generated records of yield losses at a national scale for grassland (more than 30%) and for cereals (more than 10% for soft winter wheat and winter barley). These extreme events raise the question of farm resilience in the future. Studying them makes it possible to adapt risk management policy to climate change. Therefore, the objective of this paper was to analyze the frequency and the intensity of extreme drought in 2050 and their impact on crop yield losses (grassland and cereals) in France. We used the DOWKI (Drought and Overwhelmed Water Key Indicator) meteorological index based on a cumulative water anomaly, which can explain droughts and their consequences on agricultural yield losses at a departmental scale. Then, using the ARPEGE-Climat Model developed by Meteo-France, DOWKI was projected in 2050 and grassland, soft winter wheat, and winter barley yield losses were simulated. The results compare the frequency and intensity of extreme droughts between the climate in 2000 and 2050. Our results show that the frequency of extreme droughts (at least as intense as in 2003) doubled in 2050. In addition, the yield losses due to 10-year droughts increased by 35% for grassland and by more than 70% for cereals. [ABSTRACT FROM AUTHOR]

Background The Hospital Frailty Risk Score (HFRS) has made it possible internationally to identify subgroups of patients with characteristics of frailty from routinely collected hospital data. Objective To externally validate the HFRS in France. Design A retrospective analysis of the French medical information database. Setting 743 hospitals in Metropolitan France. Subjects All patients aged 75 years or older hospitalised as an emergency in 2017 (n  = 1,042,234). Methods The HFRS was calculated for each patient based on the index stay and hospitalisations over the preceding 2 years. Main outcome measures were 30-day in-patient mortality, length of stay (LOS) >10 days and 30-day readmissions. Mixed logistic regression models were used to investigate the association between outcomes and HFRS score. Results Patients with high HFRS risk were associated with increased risk of mortality and prolonged LOS (adjusted odds ratio [aOR] = 1.38 [1.35–1.42] and 3.27 [3.22–3.32], c-statistics = 0.676 and 0.684, respectively), while it appeared less predictive of readmissions (aOR = 1.00 [0.98–1.02], c-statistic = 0.600). Model calibration was excellent. Restricting the score to data prior to index admission reduced discrimination of HFRS substantially. Conclusions HFRS can be used in France to determine risks of 30-day in-patient mortality and prolonged LOS, but not 30-day readmissions. Trial registration: Reference ID on clinicaltrials.gov: ID: NCT03905629. [ABSTRACT FROM AUTHOR]

Résumé: Le développement du cerveau humain consiste en une série de processus spatiotemporels complexes. Le neurodéveloppement est le processus de développement des neurones (incluant la prolifération, la migration, la différenciation, la synaptogenèse, l'apoptose, la gliogenèse, la myélinisation) qui s'étend principalement de la période embryonnaire à l'adolescence. Des modifications de l'environnement, notamment in utero , peuvent générer des altérations irréversibles du neurodéveloppement. Au même titre que les infections, le stress ou les carences nutritionnelles de la mère, l'exposition aux polluants chimiques environnementaux est suspectée d'être impliquée dans les perturbations du neurodéveloppement possiblement responsables d'atteintes sensorimotrices, cognitives ou comportementales et de l'incidence croissante des troubles cliniques du neurodéveloppement (tels que les troubles du spectre autistique [TSA] et le trouble déficit de l'attention/hyperactivité [TDAH]) chez les enfants. Selon l'ensemble des études épidémiologiques longitudinales, certaines substances chimiques relativement récentes et d'autres plus anciennes (métaux toxiques, polluants organiques persistants, pesticides, bisphénols, phtalates, particules fines provenant de la pollution atmosphérique, etc.) sont associées aux perturbations et troubles du neurodéveloppement. Les effets observés en épidémiologie sont compatibles avec les mécanismes d'action de ces substances chimiques sur le neurodéveloppement. Les mesures de biomarqueurs des substances chimiques chez les femmes enceintes et les enfants récemment réalisées en France et en Europe attestent d'une exposition réelle à ces substances pendant les périodes de vulnérabilité neurodéveloppementale et du risque potentiel associé. Neurodevelopment is the process of the development of neurons: their proliferation, migration, differentiation, synaptogenesis, apoptosis, gliogenesis and myelination. It extends from the embryonic period through adolescence. Environmental changes particularly in utero , can lead to irreversible neurodevelopmental alterations. Exposure to environmental chemical pollutants, as to maternal infections, stress and nutritional deficiencies, has been suspected of involvement in neurodevelopmental disturbances responsible for sensorimotor, cognitive or behavioural impairment and for the increasing incidence of clinical neurodevelopmental disorders (such as autism spectrum disorders and attention deficit/hyperactivity disorder) in children. According to the longitudinal epidemiological studies, some chemicals of relatively recent concern, as well as older chemicals (toxic metals, persistent organic pollutants, pesticides, bisphenols, phthalates, and fine particles from air pollution), are associated with neurodevelopmental disorders. The effects observed in epidemiology are consistent with the mechanisms of action of these chemicals on neurodevelopment. Biomarker measurements of chemicals in pregnant women and children recently carried out in France and Europe attest to exposure to these substances during periods of neurodevelopmental vulnerability and to the potential risk associated with it. [ABSTRACT FROM AUTHOR]

Objectives: To assess the performance of non-invasive prenatal testing (NIPT) for achondroplasia using high-resolution melting (HRM) analysis, and to propose an optimal diagnostic strategy combining ultrasound examination and cell-free fetal DNA (cffDNA) analysis.Methods: In this prospective multicenter study, cffDNA was extracted from blood of pregnant women at risk for fetal achondroplasia (owing to paternal achondroplasia, previous affected child or suspected rhizomelic shortening) and of pregnant low-risk controls. The presence of either one of the two main fibroblast growth factor receptor 3 gene (FGFR3) mutations was determined using HRM combined with confirmation by SNaPshot minisequencing. Results were compared with phenotypes obtained using three-dimensional computed tomography or postnatal examination, and/or molecular diagnosis by an invasive procedure. Fetal biometry (head circumference and femur length) was analyzed in order to develop a strategy in which cffDNA analysis for diagnosis of achondroplasia is offered only in selected cases.Results: Eighty-six blood samples from women at risk for fetal achondroplasia and 65 from controls were collected. The overall sensitivity and specificity of NIPT were 1.00 (95% CI, 0.87-1.00) and 1.00 (95% CI, 0.96-1.00), respectively. Critical reduction in femur length of affected fetuses could be observed from 26 weeks' gestation.Conclusions: HRM combined with SNaPshot minisequencing is a reliable method for NIPT for achondroplasia. Its implementation in routine clinical care combined with ultrasonography is an efficient strategy for the non-invasive diagnosis of achondroplasia. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

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Fix data are available on the management of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We conducted a retrospective study of 100 pregnant women with SARS-CoV-2 infection in 4 obstetric units in the Paris metropolitan area of France during March 12-April 13, 2020. Among patients, 52 (52%) were hospitalized, 10 (10%) in intensive care units (ICUs). Women with higher body mass indexes (BMIs; median 30.7 kg/m2) were more likely to be hospitalized in ICUs than other women (median BMI 26.2 kg/m2). Women hospitalized in ICUs had lower lymphocyte count at diagnosis (median 0.77 × 109 cells/L) than women not hospitalized in ICUs (median lymphocyte count 1.15 × 109 cells/L). All women requiring oxygen >5 L/min were intubated. Clinical and laboratory evaluation of SARS-CoV-2-positive pregnant women at the time of diagnosis can identify patients at risk for ICU hospitalization. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate the percentage of oocyte donors who regretted their donation at least 3 years later. Between December 2018 and January 2019, this single-centre study sought to contact by telephone all women who had donated oocytes during the 6-year period from 2010 to 2015 at the Lille Centre for the study and storage of eggs and spermatozoa (CECOS). Among 118 women, 72 responded to the questionnaire by telephone and were included in the study. The response rate was 61%. No woman regretted having donated an oocyte, and 89% said that they would do it again in the same situation. The survey distinguished two types of donors: 'relational' (58%) and 'altruistic' (42%); some of their responses differed. Ninety per cent of the women had talked about the donation to family and friends. Among them, 74% felt supported by their family and friends, and 72% by their partner. The donation was something that 76% of the women sometimes thought about; 83% felt that this donation was something useful that they had accomplished. Finally, most donors felt that oocyte donation should remain unremunerated and anonymous. None of the donors we interviewed regretted their donation. In France, the current principles governing this donation appear satisfactory to oocyte donors. [ABSTRACT FROM AUTHOR]

Objective: To study changes in the reasons for third-trimester termination of pregnancy (TOP) for fetal anomalies over a 20-year period in France.Study Design: We compared a consecutive series of third-trimester TOPs from a single centre in 2005-2014 to those performed by Dommergues et al. in a similar centre in 1986-1994, using the same criteria.Main Outcome Measures: The process leading to late TOP, using the same categories in both studies.Results: In the present series, 205 of 1409 TOPs were performed in the third trimester, vs. 305/956 in the historical series. There were 33 (16.1 %) diagnoses missed at the screening before the third trimester, 55 (26.8 %) cases in which the anomaly was impossible to diagnose until the third trimester, 86 (42 %) cases in which fetal prognosis could not be established until the third trimester despite earlier diagnosis, 31 (15.1 %) TOPs postponed to allow more time for the women/couples to contemplate, versus respectively 113 (37 %), 55 (18 %), 122 (40 %), and 15 (5%) in the historical series.Conclusion: There was a significant drop in the rate of anomalies missed earlier. The increase in late TOP due to couples requiring additional time for contemplation might result from changes in counselling processes. [ABSTRACT FROM AUTHOR]

Objective: To evaluate neonatal mortality and morbidity up to 6 months in neonates with congenital diaphragmatic hernia (CDH) with or without a hernia sac.Methods: Seventy-two cases of isolated CDH were included in a retrospective single-center study between January 2010 and December 2016. Hernia sac was defined at the time of surgery or at postmortem examination if the neonate died before surgery.Results: Seventeen newborns (23.6%) had a hernia sac. Survival at 6 months was significantly greater for isolated CDH with a hernia sac: 100% versus 63.6% (P = .003). High-frequency oscillatory ventilation was used significantly more in the no hernia sac group (P = .04). At surgery, the need for patch repair was significantly lower in the hernia sac group: 12% versus 50% (P = .005). The prenatal observed/expected lung-to-head ratio was significantly higher in the hernia sac group than in the no hernia sac group: 49.7% versus 38.6% (P < .05).Conclusion: The presence of a hernia sac in CDH is associated with better outcome, especially survival at 6 months. If the presence of a hernia sac is recognized as a particular entity, which carries a good prognosis, it is necessary to be able to diagnose it prenatally, especially in the era of prenatal fetal surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several studies suggest that exposure to organophosphate insecticides (OP) during pregnancy impairs neurodevelopment in children. OBJECTIVES: We evaluated associations between biomarkers of prenatal and postnatal OP exposure and cognitive function of 6-year-olds in a French longitudinal birth cohort. METHODS: In 2002-2006, the PELAGIE mother--child cohort enrolled pregnant women from Brittany. For a random subcohort, we measured nonspecific dialkylphosphate metabolites (DAP) of OP in one maternal urine sample, collected before 19 weeks' gestation, and in one urine sample collected from their 6-year-old children. Six subtests of the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) were administered when the children were 6 years of age to evaluate cognitive function (n = 231). Linear regression models controlling for factors including maternal intelligence and the Home Observation for Measurement of the Environment score were used. RESULTS: WISC-IV scores were not significantly associated with prenatal or childhood total DAP metabolites. WISC verbal comprehension score was significantly higher in association with the highest maternal urinary concentrations of diethylphosphate (DE) metabolites (5.5; 95% CI: 0.8, 10.3 for > 13.2 nmol/L vs. < LOQ), whereas WISC working memory score was significantly lower in association with the highest urinary concentrations of DE metabolites at age 6 years (-3.6; 95% CI:-7.8,-0.6 for > 11.1 nmol/L vs. < LOD). CONCLUSION: We found no evidence that prenatal OP exposure adversely affected cognitive function in 6-year-olds, perhaps because of the population's socioeconomic status, which was higher than in previous studies, though other causal and noncausal explanations are also possible. The negative association between WISC score and concurrent DE urinary concentrations requires replication by longitudinal studies investigating childhood OP exposure. [ABSTRACT FROM AUTHOR]

Objective. Coexistence of ANCA-associated vasculitis (AAV) and IBD is a rare condition that is rarely described in the literature. The aim of the study was to describe the main characteristics of patients presenting with both IBD and AAV. Methods. A retrospective study of AAV patients in the French Vasculitis Study Group cohort who also had a diagnosis of IBD was conducted. We reviewed the medical records and outcomes of these patients. Results. We identified 11 patients with AAV and IBD. Four patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss) also had ulcerative colitis and seven patients with granulomatosis with polyangiitis (GPA) had Crohn's disease. No Crohn's disease was observed in eosinophilic GPA and no ulcerative colitis in GPA. IBD started before AAV manifestations in six cases, simultaneously in two cases and after AAV manifestations in three cases. Conclusion. Coexistence of IBD and AAV is a rare condition. The therapeutic management of these patients includes corticosteroids in all cases and immunosuppressive drugs in some patients. Coexistence of IBD and AAV might be explained by common underlying inflammatory responses and cytokine profiles polarized towards either Th1 or Th2. Finally, in the presence of digestive manifestations in the context of AAV, the hypothesis of IBD should be assessed. [ABSTRACT FROM AUTHOR]

Background: Glycol ethers are present in a wide range of occupational and domestic products. Animal studies have suggested that some of them may affect ovarian function. Objective: We examined the relation between women's exposure to glycol ethers and time to pregnancy. Methods: We used chromatography coupled to mass spectrometry to measure eight glycol ether metabolites in urine samples from randomly selected women in the PELAGIE mother-child cohort who had samples collected before 19 weeks of gestation. Using time to pregnancy information collected at the beginning of the pregnancy (women were asked how many months it took for them to conceive), we estimated associations between metabolite levels and time to pregnancy in 519 women with complete data using discrete-time Cox proportional hazards models to adjust for potential confounders. Results: We detected glycol ether metabolites in 6% (for ethoxyacetic acid) to 93% (for phenoxyacetic and butoxyacetic acids) of urine samples. Phenoxyacetic acid was the only metabolite with a statistically significant association with longer time to pregnancy [fecundability OR = 0.82; 95% CI: 0.63, 1.06 for the second and third quartile combined; fecundability OR = 0.70; 95% CI: 0.52, 0.95 for a fourth-quartile (≥ 1.38 mg/L) vs. first-quartile concentration (< 0.14 mg/L)]. This association remained stable after multiple sensitivity analyses. Conclusion: Phenoxyacetic acid, which was present in most of the urine samples tested in our study, was associated with increased time to pregnancy. This metabolite and its main parent com­pound, 2-phenoxyethanol, are plausible causes of decreased fecundability, but they may also be surrogates for potential coexposures to compounds frequently present in cosmetics. [ABSTRACT FROM AUTHOR]

Objective Earlier studies of eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA), with limited patient numbers and followup durations, demonstrated that clinical presentation at diagnosis, but not outcome, differed according to antineutrophil cytoplasmic antibody (ANCA) status. This study was undertaken to describe the main characteristics of a larger patient cohort and their long-term outcomes. Methods A retrospective study of EGPA patients in the French Vasculitis Study Group cohort who satisfied the American College of Rheumatology criteria and/or Chapel Hill definitions was conducted. Patient characteristics and outcomes were compared according to ANCA status and year of diagnosis. Results We identified 383 patients diagnosed between 1957 and June 2009 (128 [33.4%] before 1997 or earlier) and followed up for a mean ± SD of 66.8 ± 62.5 months. At diagnosis, their mean ± SD age was 50.3 ± 15.7 years, and 91.1% had asthma (duration 9.3 ± 10.8 years). Main manifestations included peripheral neuropathy (51.4%); ear, nose, and throat (ENT) signs (48.0%); skin lesions (39.7%); lung infiltrates (38.6%); and cardiomyopathy (16.4%). Among the 348 patients tested at diagnosis for ANCA, the 108 ANCA-positive patients (31.0%) had significantly more frequent ENT manifestations, peripheral neuropathy, and/or renal involvement, but less frequent cardiac manifestations, than the ANCA-negative patients. Vasculitis relapses occurred in 35.2% of the ANCA-positive versus 22.5% of the ANCA-negative patients ( P = 0.01), and 5.6% versus 12.5%, respectively, died ( P < 0.05). The 5-year relapse-free survival rate was 58.1% (95% confidence interval [95% CI] 45.6-68.6) for ANCA-positive and 67.8% (95% CI 59.8-74.5) for ANCA-negative patients ( P = 0.35). Multivariable analysis identified cardiomyopathy, older age, and diagnosis during or prior to 1996 as independent risk factors for death and lower eosinophil count at diagnosis as predictive of relapse. Conclusion The characteristics and long-term outcomes of EGPA patients differ according to their ANCA status. Although EGPA relapses remain frequent, mortality has declined, at least since 1996. [ABSTRACT FROM AUTHOR]

Little is known about the potential effect of climate warming on phyllosphere fungi, despite their important impact on the dynamics and diversity of plant communities. The structure of phyllosphere fungal assemblages along elevation gradients may provide information about this potential effect, because elevation gradients correspond to temperature gradients over short geographic distances., We thus investigated variations in the composition of fungal assemblages inhabiting the phyllosphere of European beech ( Fagus sylvatica) at four sites over a gradient of 1000 m of elevation in the French Pyrénées Mountains, by using tag-encoded 454 pyrosequencing., Our results show that the composition of fungal assemblages varied significantly between elevation sites, in terms of both the relative abundance and the presence-absence of species, and that the variations in assemblage composition were well correlated with variations in the average temperatures., Our results therefore suggest that climate warming might alter both the incidence and the abundance of phyllosphere fungal species, including potential pathogens. For example, Mycosphaerella punctiformis, a causal agent of leaf spots, showed decreasing abundance with elevation and might therefore shift to higher elevations in response to warming. [ABSTRACT FROM AUTHOR]

Context. The Portuguese man-o-war is a cnidaria classically found in tropical waters. It can cause serious and even life-threatening envenomation in swimmers, surfers and seafarers. Presence of the Atlantic species Physalia physalis has long been reported in European coastal waters but was always an exceptional event. Objective. To describe the experience of the Bordeaux Poison centre about Physalia stings since the first collective episode reported in 2008. Methods. Clinical retrospective description of cases series of Physalia envenomations reported to the local poison centre from 2008 to 2011 inclusive. Results. In the summer of 2008, multiple-case incident involving 40 victims were recorded on the same day on one beach in the Southern French Atlantic coast. The following year in 2009, no envenomation cases were reported in the same area, but in the next 2 years, numerous man-of-war envenomations occurred along the Aquitaine coast, that is, 154 cases in 2010 and 885 in 2011. Portuguese man-o-war stings led to severe manifestations with 15-20% of patients suffering of general symptoms that were sometimes severe enough to be considered as potentially life-threatening (8% of patients in 2011, most frequent signs: muscle pain and cramps with fasciculations, confusion and drowsiness, fainting, respiratory distress). No deaths due to Portuguese man-o-war envenomation were reported over the 4-year study period. Conclusion. The results suggest that national multidisciplinary summer surveillance program in the Aquitaine coast is required in order to provide alerts to the public, to better identify patients at risk for developing severe clinical symptoms, and hopefully to improve quality of health care. [ABSTRACT FROM AUTHOR]

The initial and continuing academic programs for teacher librarians in France have to face major changes in their content and organization. A new social request for distance learning courses crosses a changing conceptual, epistemic and technological content that demands the implementation of adapted academic policies. The creation of distance learning curricula in universities is based on three factors: - A new perspective on information culture which includes cross-cultural and critical knowledge about information, media and computer science. This "transliteracy' dimension is congruent to the logic of distance learning. - The emphasis in use and reflection on information and communication tools that are common to existing curricula and distance learning courses. - The necessity of alternative training strategies for the universities which includes experimentation of information technologies as learning tools, objects and subjects. [ABSTRACT FROM AUTHOR]

It has been suggested that prenatal exposure to insecticides adversely affects fetal growth, but the overall results have been inconsistent, partly because of the different exposure sources and exposure assessments used. In the French PELAGIE (Perturbateurs Endocriniens: Étude Longitudinale sur les Anomalies de la Grossesse, l’Infertilité et l’Enfance) mother and child cohort (2002–2006), the authors investigated the association between fetal growth and insecticide exposure (n = 1,213) using an integrated Bayesian latent variable model to include multiple exposure sources: agricultural activities, nonorganic diet, household insecticide use on plants, and household insecticide use against insects. They used a questionnaire to collect information on household use and organic diet, and a national agricultural census provided data on agricultural activities in the women’s municipalities of residence. A 0.10-cm decrease in head circumference at birth (95% credibility interval: −0.22, 0.01) was associated with fetal insecticide exposure from agricultural activities in the municipality of residence. Decreases in average birth weight (−27 g; 95% credibility interval: −59, 6) and head circumference (−0.12 cm; 95% credibility interval: −0.26, 0.01) were associated with household insecticide use to treat plants. The present results suggest an inverse association between fetal growth and prenatal insecticide exposure from nearby agricultural activity or household use. Bayesian modeling via latent variables is a natural framework for including multiple sources of exposure to environmental pollutants. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Cytomegalovirus (CMV) is the most frequent cause of congenital virus infection. Approximately 1% of newborns are infected by CMV at birth with severe consequences among 10% of them. Efficacy of hygienic counselling is nowadays established and should be spread. Objective: To evaluate pregnant women''s awareness of cytomegalovirus infection in France. Study design: Pregnant women receiving prenatal care, at any moment of their pregnancy, in two different obstetrics clinics with different information policies, were asked to complete a written questionnaire about CMV infection. Results: More than half (217/362, 60%) of the pregnant women had heard of congenital CMV infection, and most of them (72%) knew the hygiene measures to use to prevent infection. Nevertheless, most could not correctly identify the symptoms associated with congenital CMV disease. Awareness was associated with hospital''s policy concerning CMV infection information, the mother''s educational level, parity, and employment in health care. Indeed, when information is supposed to be given (hospital A), 74% (vs 34%) know congenital CMV infection and among them the knowledge is more precise. Conclusions: This study tends to confirm that there is a large gap between knowledge of CMV and the burden of this disease. To bridge this gap, women should receive education about congenital CMV. Hospital-based prenatal education increases awareness and knowledge about CMV and CMV prevention. [Copyright &y& Elsevier]

Although prenatal exposure to water disinfection by-products does not appear to affect the duration of gestation, its impact on fetal growth remains an open question. The authors studied the associations between prenatal exposure to disinfection by-products and fetal growth restriction (FGR) and preterm birth in the PELAGIE cohort, a French birth cohort comprising 3,421 pregnant women recruited between 2002 and 2006. Exposure was assessed by estimating levels of trihalomethanes (THMs) in tap water during pregnancy and maternal water use and by measuring maternal urinary levels of trichloroacetic acid (TCAA) during early pregnancy in a nested case-control design that compared 174 FGR cases, 114 preterm births, and 399 controls. Higher uptake of THMs (especially brominated THMs) was associated with a higher risk of FGR. Women with TCAA detected in their urine (>0.01 mg/L) had a higher risk of FGR than those with TCAA levels below the detection limit (adjusted odds ratio = 1.8, 95% confidence interval: 0.9, 3.7) and had an odds ratio for preterm birth below 1 (adjusted odds ratio = 0.8, 95% confidence interval: 0.3, 2.6). Results from this prospective study, the first to use a biomarker of disinfection by-product exposure, suggest that prenatal exposure affects fetal growth, but the causal agent or agents remain to be identified. [ABSTRACT FROM PUBLISHER]

The article focuses on the decorative arts in France in the nineteenth century and the Bellangé album of drawings from the Department of Prints at the Metropolitan Museum of Art in New York City that was first researched by Jean-Pierre Samoyault. The article discusses the Bellangés' workshop for which the album is named, owned by furniture-maker Pierre-Antoine Bellangé and his song, Louis-Alexandre Bellangé, commissions the workshop took on such as furniture for United States President James Monroe and the Louvre Museum in Paris, France, as well as the dialogue between the Bellangé workshop and other firms such as that of designer Jean-Démosthène Dugourc and Jacob-Desmalter.

Background: Evidence of a dose-response relationship between prenatal exposure to methylmercury (MeHg) and neurodevelopmental consequences in terms of IQ reduction, makes it possible to evaluate the economic consequences of MeHg exposures. Objective: To perform an economic evaluation of annual national benefits of reduction of the prenatal MeHg exposure in France. Methods: We used data on hair-Hg concentrations in French women of childbearing age (18-45 years) from a national sample of 126 women and from two studies conducted in coastal regions (n = 161and n = 503). A linear dose response function with a slope of 0.465 IQ point reduction per µg/g increase in hair-Hg concentration was used, along with a log transformation of the exposure scale, where a doubling of exposure was associated with a loss of 1.5 IQ points. The costs calculations utilized an updated estimate of £2008 17,363 per IQ point decrement, with three hypothetical exposure cut-off points (hair-Hg of 0.58, 1.0, and 2.5 µg/g). Results: Because of higher exposure levels of women in coastal communities, the annual economic impacts based on these data were greater than those using the national data, i.e. £ 1.62 billion (national), and £ 3.02 billion and £ 2.51 billion (regional), respectively, with the linear model, and £ 5.46 billion (national), and € 9.13 billion and £ 8.17 billion (regional), with the log model, for exposures above 0.58 µg/g. Conclusions: These results emphasize that efforts to reduce MeHg exposures would have high social benefits by preventing the serious and lifelong consequences of neurodevelopmental deficits in children. [ABSTRACT FROM AUTHOR]

The article discusses the identification of two tables made by Paris, France cabinetmaker Louis-François Bellangé in the early 1820s. The article describes the porcelain-mounted tables found in the Doheny Mansion, California and a French private collection. Other topics include Bellangé's life and career, the provenance of the tables, Bellangé's furniture as inspired by the period of King Louis XVI, and the concept of curiosity furniture.

BACKGROUND: Despite evidence of atrazine toxicity in developing organisms from experimental studies, few studies--and fewer epidemiologic investigations--have examined the potential effects of prenatal exposure. OBJECTIVES: We assessed the association between adverse birth outcomes and urinary biomarkers of prenatal atrazine exposure, while taking into account exposures to other herbicides used on corn crops (simazine, alachlor, metolachlor, and acetochlor). METHODS: This study used a case-cohort design nested in a prospective birth cohort conducted in the Brittany region of France from 2002 through 2006. We collected maternal urine samples to examine pesticide exposure biomarkers before the 19th week of gestation. RESULTS: We found quantifiable levels of atrazine or atrazine mercapturate in urine samples from 5.5% of 579 pregnant women, and dealkylated and identified hydroxylated triazine metabolites in 20% and 40% of samples, respectively. The presence versus absence of quantifiable levels of atrazine or a specific atrazine metabolite was associated with fetal growth restriction [odds ratio (OR) = 1.5; 95% confidence interval (CI), 1.0-2.2] and small head circumference for sex and gestational age (OR = 1.7; 95% CI, 1.0-2.7). Associations with major congenital anomalies were not evident with atrazine or its specific metabolites. Head circumference was inversely associated with the presence of quantifiable urinary metolachlor. CONCLUSIONS: This study is the first to assess associations of birth outcomes with multiple urinary biomarkers of exposure to triazine and chloroacetanilide herbicides. Evidence of associations with adverse birth outcomes raises particular concerns for countries where atrazine is still in use. [ABSTRACT FROM AUTHOR]

Productivity, nutrient input, nutrient uptake, and release rates were determined for a coral-dominated reef flat at La Réunion, France, to assess the influence of groundwater nitrogen on carbon and nutrient budgets. Water samples were collected offshore in the ocean, at the reef crest and back reef for nutrients, picoplankton, pH, and total alkalinity. Volume transport of ocean water across the reef flat was measured using both current meters and drogues. Groundwater advected onto the reef flat and mixed with incoming ocean water. Metabolic rates for the reef community were determined to be: gross primary production = 1,000 mmol C m d, community respiration = 960 mmol C m d, and community calcification = 210 mmol C m d. Across the reef flat, silicate behaved conservatively, there was net uptake of phosphate (0.06 mmol P m d) and net release of nitrate, ammonia, dissolved and particulate organic nitrogen (total 7.0 mmol N m d). Groundwater nitrate contributed 37% of the increase in nitrate plus ammonia. The first-order mass transfer coefficient of phosphate was 3.3 m d, and for nitrate plus ammonia, 5.9 m d. Gross N and P uptake from estimates of mass transfer and uptake of particles were 0.37 mmol P m d and 7.2 mmol N m d, respectively giving an N:P uptake ratio of 20:1. Thus, the elevation of nitrogen across the reef flat maintains a high N:P flux, enhancing algal growth downstream of the transect. We conclude that net community production (40 mmol C m d) was sustained by net uptake of phosphate from the ocean and net uptake of new nitrogen from groundwater. [ABSTRACT FROM AUTHOR]

Objective [ABSTRACT FROM AUTHOR]

Since the spring of 1999, new French radiation protection legislation has allowed the use of passive dosemeters, other than the silver emulsion film badge, for the measurement of Hp(10). Faced with the eventual obsolescence of its dosimetry system, Electricité de France (EDF, the French electricity provider) initiated a comparative study of passive dosemeters, based on different technologies, that had received accreditation by national laboratories and regulatory bodies, namely: TLD, RPL and OSL. An extended field study in nuclear power stations and medical X-ray departments has shown that all technologies provide compatible dosimetric estimates. It also showed that the selected dosemeters based on RPL and OSL technologies gave better results due to their energy responses and to a lower detection threshold compliant with the new regulation. A final suggestion to implement a new OSL based dusimetric system is made due to its overall performance and to its lower cost of implementation. [ABSTRACT FROM AUTHOR]

The article provides information on Libre Accès aux Rapports scientifiques et techniques (LARA), a national repository for grey reports created by the Institut de l'Information Scientifique et Technique (INIST) in France. The aim of LARA is to allow direct and open access to the documents through the Internet, as well as to increase their visibility to the scientific community. INIST-Centre National de Recherche Scientifique holds a report collection of more than 60,000 grey documents in paper copies. In the context of scientific publishing and evaluation of researchers, reports are useful to obtain funding for the laboratory, but are not taken into consideration for the evaluation of searchers.

Describes the taxation system in France. Scope of the French corporate income tax; Rate of the corporate income tax; Taxation of dividends; Social security contributions on salaries and payments to employees.

Deals with the integration of domain knowledge to improve the landcover classification of a watershed near Brittany, France in a sequence of remotely-sensed images. Aspects of misclassification resulting from usual classifiers; Landcover types in the watershed; Discussion of the refinement problem as the landcover classification of a sequence of images.

International policies promote renewable forms of energy to mitigate climate change. In Europe, the production of electricity using wood biomass represents one of the most popular energy alternatives. In 2012, France initiated a large-scale strategy to develop wood biomass energy. The biggest wood biomass power-plant project has been developed in the French Mediterranean area and its huge size raises several issues for the short- and long-term sustainability of local forests and associated economic sectors. The French Mediterranean forests provide four types of economic goods (private, club, common, and public goods) and multiple ecosystem services, which makes them complex to manage under an energy transition policy. In this paper, we applied three qualitative methods, namely interviews, participative workshops, and observant participation, and three conceptual models, namely (i) Ostrom's (2010) self-organization key conditions, (ii) the types of economic goods classified according to their excludability and rivalry properties, and (iii) the ecosystem service categorization system of the Millennium Ecosystem Assessment (2005). With our methods, we show that the renewable strategy chosen in France replicates the current centralized production model based on fossil and nuclear fuels. Thus, we demonstrate that European, national, and local authorities fail to consider the multiple ecosystem services that forest management strategies should include to face the energy transition, climate change, and the other ecological challenges of the 21st century. [ABSTRACT FROM AUTHOR]

The role of parental occupational exposure in childhood brain tumors was investigated in a population-based case-control study grouping 251 cases and 601 controls from three European centers: Milan (Italy), Paris (France), and Valencia (Spain). Parental occupational exposure to solvents and polycyclic aromatic hydrocarbons (PAH) during the five-year period before birth was estimated using a job-exposure matrix developed earlier in the same countries. Odds ratios (OR) of brain tumors for each occupation and occupational exposure were estimated by logistic regression, adjusting for child's age, gender, exposure to tobacco smoke and ionizing radiation, mother's age and years of schooling, and center. The risk of childhood brain tumors rose when fathers worked in agriculture (OR = 2.2, 95 percent confidence interval [CI] = 1.0-4.7) and motor-vehicle-related occupations. In the latter group, the risk increased for primitive neuroectodermal tumors in particular (OR = 2.7, CI = 1.1-6.6). Astroglial tumors were more frequent among children of mothers in health services (OR = 2.2, CI = 1.0-4.9). Paternal exposure to PAHs was associated with an increased, but not dose-related, risk of primitive neuroectodermal tumors (OR = 2.0, CI = 1.0-4.0), and maternal exposure to solvents at a high level was associated with an increased risk of both astroglial (OR = 2.3, CI = 0.9-5.8) and primitive neuroectodermal tumors (OR = 3.2, CI = 1.0-10.3). [ABSTRACT FROM AUTHOR]

• Low and high bar modes originate from water discharge variations. • In turn, this induces complex compound bar formation. • Sediment sorting patterns differ between unit and compound bar patterns. • Sediment sorting does not modify bar morphodynamics if sediment mobility is high. • Floods decrease the degree of sediment sorting. Bars are large sediment deposits alternating with deeper areas that arise from alluvial river bed instability and forcing. The present study aimed at investigating the combined influence of flow and longitudinal width variations on the co-evolution between bar pattern and sediment sorting in a sandy-gravel river reach. To this goal, a fully non-linear 2D numerical model was developed to reproduce the morphodynamic behavior of bars in a reach of the Loire River consisting in a typical channel expansion/contraction. Numerical results showed that varying water discharge promoted a competition between low and high bar modes: i.e., from alternate to multiple bar patterns. Low bar modes were associated with coarse sediment over bar tops and fine sediment in pools, and this sorting pattern was inverted for higher bar modes. Surface sediment was coarser and the degree of sediment sorting was greater after periods of low than high flow. Due to high sediment mobility, sediment sorting did not significantly modify bar morphodynamics. [ABSTRACT FROM AUTHOR]

Extreme weather events have strong impacts on agriculture and crop insurance. In France, drought (2003, 2011, 2017, and 2018) and excess of water (2016) are considered the most significant events in terms of economic losses. The crop (re)insurance industry must estimate its financial exposure to climatic events in terms of the average annual losses and potential extreme damages. Therefore, the objective of this paper was to develop a model that links meteorological indices to crop yield losses with a specific focus on extreme climatic events. We designed a meteorological index (DOWKI: Drought and Overwhelmed Water Key Indicator) based on a water balance cumulative anomaly that can explain drought and excess of water at the department scale. We propose a crop damage model calibrated by combining historical yield records and the DOWKI values. To estimate the financial exposure of insured crops at a national level, stochastic simulations of the DOWKI were performed to produce one thousand years of yield losses. Our objective was to estimate the effect of climatic extremes affecting the global production. Simulated average annual losses and the possible maximum claim for three crops (soft winter wheat, winter barley, and sunflower) are presented in the results. [ABSTRACT FROM AUTHOR]

Background: Mitigating the effect of linear transport infrastructure (LTI) on fauna is a crucial issue in road ecology. Wildlife crossing structures (tunnels or overpasses) are one solution that has been implemented to restore habitat connectivity and reduce wildlife mortality. Evaluating how these crossings function for small wildlife has often been recommended but, mainly due to technical limitations, is not often conducted in practice or only as short-term monitoring (less than 1 year). In this study, we developed and tested an automated device that records the detailed behaviour of animals when using wildlife tunnels. The method is based on marking and detecting individuals with RFID (radio-frequency identification) tags and allows small animals to be tracked. Composed of four antennas (detectors) placed at roughly 2 m intervals, the system was tested in a tunnel in northern France in the summer of 2017. One species of amphibian (the toad Bufo spinosus, n = 13) and two carabids (the ground beetles Carabus coriaceus and Carabus nemoralis, respectively, n = 3 and n = 4), marked beforehand with PIT (passive integrated transponder) tags, were recorded when they crossed these detectors. This allowed individual trajectories, including crossing speed, to be estimated. Results: We found that 12 of the 13 toads and 3 of the 7 ground beetles successfully crossed the entire wildlife passage of 7 m long. The detection rate of each detector varied from 8.33 to 100%, with a mean of 52.08%. All individuals were recorded by at least one detector. We observed high variability in the crossing characteristics of toads (mean transit duration = 41 min and 15 s ± 25 min) and ground beetles (6 h 11 min ± 3 h 30 min). The system provided information on precise trajectories (e.g., crossing speed, U-turns, distance travelled in the tunnel, proportion of individuals reaching the exit, etc.) for each individual, in a context of tunnel crossing. Conclusion: The system allowed us to record small animal behaviour in the context of tunnel crossing in which other types of tracking (e.g. radio-tracking) or detection (e.g. camera traps) are not effective. It also opens the possibility for a range of experiments that would contribute to a better understanding of the behaviour of small animals in tunnels, allowing a comparison of tunnel characteristics (such as size, building material, substrate, etc.) with the aim of increasing wildlife use of the tunnel and proposing guidelines for the construction and maintenance of these mitigation measures. [ABSTRACT FROM AUTHOR]

Examines the respiratory effects of environmental pollution by asbestos inside university buildings in Paris, France. Definition of different levels of exposure; Analysis on atmospheric measurements by electron microscopy; Prevalence of pleural thickenings on lateral chest x-ray in occupational and environmental exposure.

Abstract: Modelling stream water pollution by herbicides in agricultural areas is a critical issue since numerous and incompletely known processes are involved. A decision-oriented model, SACADEAU-Transf, which represents water and pesticide transfer in medium-sized catchments (10–50km2) is presented. This model aims at evaluating the effect of land use, agricultural practice and landscape on the contamination of stream water in rural catchments. The processes are represented in an easily understandable way with a moderate amount of information, producing semi-quantitative and spatialized outputs. Modelling focuses on the first few months after herbicide application when high levels of contamination are generally observed, by considering transfer through the catchment area via surface and subsurface flow. The surface flow, based on a tree plot network representation of the catchment, is controlled by soil-surface properties and saturated conditions. The subsurface flow based on Topmodel concepts is controlled by the topography. Herbicide transfer is coupled to water transfer by taking into account the main characteristics of the chemicals. The model simulates the daily water and herbicide outflow at the outlets of the farmers'' fields as well as from the catchment. Preliminary results on maize herbicide transfer are presented for an agricultural catchment with an area of 17km2 located in north-western France. The relevance of SACADEAU-Transf model is discussed in view of the qualities required for the decision-oriented models developed for improving agro-environmental management. [Copyright &y& Elsevier]

Background. – In emergency department (ED) the prevalence of infectious diseases is high but anti-microbial drugs are misused.Objective. – The authors had for aim to identify antibiotic use, defined either as a first prescription (FP), interruption (IP), replacement (RP), or continuation (CP) of a previous antibiotic.Methods. – Patients, 18 years of age or more, were included if 1) FP, or IP, or RP, or CP was decided 2) they agree to a telephone follow-up at day 3. They were sorted in 5 categories according to a pre-test evaluation of disease acuteness (PDA) published in 1994, in order to compare them to the standard French EW patient.Results. – From December 11 to December 24, 2000, 33 of the 34 EWs reported 38,859 patients; 21,909 were non-trauma patients and 2,326 (11.2%) who were presumed to be infected were given an antibiotic in 77.3% of the cases. Extrapolated to all 34 EWs, infectious diseases prevalence would be 12.86% of non-trauma patients. The 34 EWs included 1,981 patients, aged 52 ± 24 years. FP was prescribed in 77.3%, RP in 14.5%, CP in 5% and IP in 3.2%. The main infections were respiratory (37.4%), urinary (20.4%), skin (18.6%), and ENT (12%). The major antibiotics used were penicillins (57.2%), fluoroquinolones (20.8%), and 3GC (10.4%). The patients’PDA differed significantly from that of the standard French EW patient (p<10–4). One thousand and eighty-nine (55%) were hospitalized. One thousand and eight-hundred-twenty were followed-up, with 1.4% reported dead, 3.9% who did not comply, and 23.2% whose antibiotic therapy was modified by a physician. [Copyright &y& Elsevier]

Objective: To assess neonatal morbidity and mortality according to whether cephalic second twins were born after internal version followed by total breech extraction or after instructions to push. We hypothesized that interval version would result in shorter intertwin delivery intervals and lower cesarean delivery rates for the second twin and therefore better neonatal outcomes.Methods: These planned analyses of the JUMODA (JUmeaux MODe d'Accouchement) cohort, a national prospective population-based study of twin deliveries, examined births of cephalic second twins after vaginal birth of the first twin at or after 32 weeks of gestation. The internal version group of second twins born in breech presentation after obstetric maneuvers was compared with the pushing group, comprising those born in cephalic presentation. The primary outcome was a composite of neonatal morbidity and mortality. Multivariate modified Poisson regression models were used to control for potential confounders.Results: Of 2,256 cephalic second twins, 487 (21.6%) were born in breech presentation after internal version and total breech extraction and 1,769 (78.4%) in cephalic presentation after pushing. Composite neonatal morbidity and mortality was not lower in the internal version (17/487 [3.5%]) compared with the pushing group (38/1,769 [2.1%]; adjusted relative risk [aRR] 1.73 [95% CI 0.98-3.05]), although median [quartile 1-quartile 3] intertwin delivery intervals were shorter (5 [4-8] vs 8 [5-12] minutes, P<.001) and the cesarean delivery rate for the second twin lower (5/487 [1.0%] vs 66/1,769 [3.7%], P=.002). Subgroup analyses showed no difference between groups at or after 37 weeks of gestation but higher composite neonatal morbidity and mortality after internal version before 37 weeks (14/215 [6.5%] vs 26/841 [3.1%]; aRR 2.18 [95% CI 1.15-4.13]). Secondary analyses according to center expertise in the overall population and stratified by gestational age yielded concordant results.Conclusion: Although our sample size precluded a robust assessment for small differences in outcomes between groups, internal version followed by total breech extraction of cephalic second twins was not associated with better neonatal outcomes than pushing. [ABSTRACT FROM AUTHOR]

• Unadjusted analysis showed Cd and Cr associated with diminished ovarian reserve. • Multivariate analyses showed no significant metal association with ovarian reserve. • Metal mixture analyses resulted in a non-significant effect on ovarian reserve. • There was no evidence of interaction between metals in our BKMR analysis. Do heavy metals affect the risk of diminished ovarian reserve (DOR) in women of reproductive age? A total of 139 cases and 153 controls were included between 2016 and 2020. The participants were aged between 18 and 40 years and attended consultations for couple infertility in one of four fertility centres in western France. Cases of DOR were defined as women with an antral follicle count less than 7, anti-Müllerian hormone levels 1.1 ng/ml or less, or both. Controls were frequency matched on age groups and centres, and were women with normal ovarian reserve evaluations, no malformations and menstrual cycles between 26 and 35 days. Heavy metals (lead, mercury, cadmium and chromium) were measured in whole blood at inclusion. Single-exposure associations were examined with multivariable logistic regressions adjusted on potential confounders. Mixture effects were investigated with quantile g-computation and Bayesian kernel machine regression (BKMR). Chromium as a continuous exposure was significantly associated with DOR in unadjusted models (OR 2.07, 95% CI 1.04 to 4.13) but the association was no longer significant when confounders were controlled for (adjusted OR 2.75, 95% CI 0.88 to 8.60). Similarly, a statistically significant association was observed for the unadjusted second tercile of cadmium exposure (OR 1.87, 95% CI 1.06 to 3.30); however, this association was no longer statistically significant after adjustment. None of the other associations tested were statistically significant. Quantile g-computation and BKMR both yielded no significant change of risk of DOR for the mixture of metals, with no evidence of interaction. Weak signals that some heavy metals could be associated with DOR were detected. These findings should be replicated in other studies. [Display omitted] [ABSTRACT FROM AUTHOR]